Inflammation of the middle ear - seen most frequently in children younger than 3 years
Pathophysiology
RISK FACTORS:
- Following common cold
- Adenoidal hypertrophy
- Cleft palate
- Down syndrome
- Eustachian tube dysfunction
Bacterial pathogens: Most cases are due to
- bacteria “Streptococcus pneumoniae , Moraxella catarrhalis and H. influenza are the two most common”,
- although viruses such as influenza virus and rhinoviruses have been implicated..
Clinical features:
- Classically, otitis media presents with (Otalgia)= ear pain, which may be severe. If the drum perforates, the pain is relieved, and a purulent discharge may follow= Otorrhea. Also may be , Fever .
- Others as Recent onset of anorexia ,Irritability ,Vomiting , Diarrhea
- There may be a degree of hearing impairment .
- The diagnosis is made clinically by otoscope
otoscopic findings of the tympanic membrane :Opacity, Bulging
Erythema ,Middle ear effusion (MEE)
Treatment:
- Spontaneously settled in most children.
- Antibiotics were most useful in patients under 2 years with bilateral acute otitis media and patients with perforation and discharge.
- If antibiotic treatment is to be given, it should be effective against the 3 main bacterial pathogens: S. pneumoniae, H. influenza and S. pyogenes.
- So, the broader-spectrum amoxicillin and ampicillin, amoxicillin/clavulanate or ceftriaxone are preferred.